American Healthcare REIT, Inc 10-Q for FY2022 Q2

American Healthcare REIT, Inc. (AHR)

10-Q 2022-08-15 For: 2022-06-30

Added on April 10, 2026

About this 10-Q

American Healthcare REIT, Inc filed this 10-Q on August 15, 2022, covering the quarter ended June 30, 2022 (FY2022 Q2).

Headline figures

Quarter ended June 30, 2022, as reported in this filing, compared with the same period a year earlier where the filing states it.

Revenue: $326.23M; up 18.0% from $276.35M a year earlier
Net loss: $17.31M; compared with a net loss of $7.68M a year earlier
Diluted EPS: -$0.07; compared with -$0.04 a year earlier

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Maryland						47-2887436
(State or other jurisdiction of incorporation or organization)						(I.R.S. Employer Identification No.)

18191 Von Karman Avenue, Suite 300 Irvine, California						92612
(Address of principal executive offices)						(Zip Code)


			Page
PART I — FINANCIAL INFORMATION

Item 1. Financial Statements (Unaudited)			3
Condensed Consolidated Balance Sheets as of June 3 0 , 2022 and December 31, 2021			3
Condensed Consolidated Statements of Operations and Comprehensive Loss for the Three and Si x Months Ended June 3 0 , 2022 and 2021			5
Condensed Consolidated Statements of Equity for the Three and S ix Months Ended June 3 0 , 2022 and 2021			6
Condensed Consolidated Statements of Cash Flows for the Six Months Ended June 3 0 , 2022 and 2021			9
Notes to Condensed Consolidated Financial Statements			11
Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations			43
Item 3. Quantitative and Qualitative Disclosures About Market Risk			60
Item 4. Controls and Procedures			62

PART II — OTHER INFORMATION

Item 1. Legal Proceedings			63
Item 1A. Risk Factors			63
Item 2. Unregistered Sales of Equity Securities and Use of Proceeds			63
Item 3. Defaults Upon Senior Securities			63
Item 4. Mine Safety Disclosures			64
Item 5. Other Information			64
Item 6. Exhibits			64
Signatures			65


	June 30, 2022		December 31, 2021
ASSETS
Real estate investments, net	$	3,491,845,000	$	3,514,686,000
Debt security investment, net	81,167,000		79,315,000
Cash and cash equivalents	59,101,000		81,597,000
Restricted cash	45,075,000		43,889,000
Accounts and other receivables, net	136,843,000		122,778,000

Identified intangible assets, net	234,914,000		248,871,000
Goodwill	212,714,000		209,898,000

Operating lease right-of-use assets, net	114,489,000		158,157,000
Other assets, net	147,752,000		121,148,000
Total assets	$	4,523,900,000	$	4,580,339,000

LIABILITIES, REDEEMABLE NONCONTROLLING INTERESTS AND EQUITY
Liabilities:
Mortgage loans payable, net(1)	$	1,134,059,000	$	1,095,594,000
Lines of credit and term loans, net(1)	1,266,691,000		1,226,634,000
Accounts payable and accrued liabilities(1)	174,179,000		187,254,000
Accounts payable due to affiliates(1)	—		866,000

Identified intangible liabilities, net	11,663,000		12,715,000
Financing obligations(1)	21,568,000		33,653,000
Operating lease liabilities(1)	104,193,000		145,485,000
Security deposits, prepaid rent and other liabilities(1)	46,450,000		48,567,000
Total liabilities	2,758,803,000		2,750,768,000

Commitments and contingencies (Note 12)

Redeemable noncontrolling interests (Note 13)	75,337,000		72,725,000

Equity:
Stockholders’ equity:
Preferred stock, $0.01 par value per share; 200,000,000 shares authorized; none issued and outstanding	—		—
Class T common stock, $0.01 par value per share; 200,000,000 shares authorized; 77,864,724 and 77,176,406 shares issued and outstanding as of June 30, 2022 and December 31, 2021, respectively	770,000		763,000
Class I common stock, $0.01 par value per share; 800,000,000 shares authorized; 186,499,872 and 185,855,625 shares issued and outstanding as of June 30, 2022 and December 31, 2021, respectively	1,865,000		1,859,000
Additional paid-in capital	2,541,504,000		2,531,940,000
Accumulated deficit	(1,024,328,000)		(951,303,000)
Accumulated other comprehensive loss	(2,653,000)		(1,966,000)
Total stockholders’ equity	1,517,158,000		1,581,293,000
Noncontrolling interests (Note 14)	172,602,000		175,553,000
Total equity	1,689,760,000		1,756,846,000
Total liabilities, redeemable noncontrolling interests and equity	$	4,523,900,000	$	4,580,339,000


	Three Months Ended June 30,				Six Months Ended June 30,
	2022		2021		2022		2021
Revenues and grant income:
Resident fees and services	$	326,225,000	$	276,352,000	$	645,199,000	$	529,378,000
Real estate revenue	51,105,000		30,642,000		103,048,000		60,665,000
Grant income	10,969,000		1,099,000		16,183,000		9,328,000
Total revenues and grant income	388,299,000		308,093,000		764,430,000		599,371,000
Expenses:
Property operating expenses	296,059,000		250,426,000		583,219,000		495,568,000
Rental expenses	14,663,000		8,119,000		29,950,000		16,174,000
General and administrative	10,928,000		7,343,000		22,047,000		14,600,000
Business acquisition expenses	1,757,000		2,750,000		1,930,000		3,998,000
Depreciation and amortization	39,971,000		26,357,000		82,282,000		52,080,000
Total expenses	363,378,000		294,995,000		719,428,000		582,420,000

Other income (expense):
Interest expense:
Interest expense (including amortization of deferred financing costs, debt discount/premium and gain/loss on debt extinguishments)	(20,345,000)		(18,490,000)		(43,670,000)		(38,855,000)
Gain in fair value of derivative financial instruments	—		1,775,000		500,000		3,596,000
(Loss) gain on dispositions of real estate investments	(73,000)		(42,000)		683,000		(377,000)
Impairment of real estate investments	(17,340,000)		(3,335,000)		(17,340,000)		(3,335,000)
Income (loss) from unconsolidated entities	638,000		(901,000)		2,024,000		(2,672,000)
Foreign currency (loss) gain	(3,607,000)		238,000		(4,994,000)		653,000
Other income	469,000		191,000		1,729,000		463,000
Total net other expense	(40,258,000)		(20,564,000)		(61,068,000)		(40,527,000)
Loss before income taxes	(15,337,000)		(7,466,000)		(16,066,000)		(23,576,000)
Income tax expense	(205,000)		(495,000)		(373,000)		(658,000)
Net loss	(15,542,000)		(7,961,000)		(16,439,000)		(24,234,000)
Net (income) loss attributable to noncontrolling interests	(1,768,000)		283,000		(3,827,000)		4,709,000
Net loss attributable to controlling interest	$	(17,310,000)	$	(7,678,000)	$	(20,266,000)	$	(19,525,000)
Net loss per Class T and Class I common share attributable to controlling interest — basic and diluted	$	(0.07)	$	(0.04)	$	(0.08)	$	(0.11)
Weighted average number of Class T and Class I common shares outstanding — basic and diluted	263,017,692		179,628,847		262,768,637		179,628,315

Net loss	$	(15,542,000)	$	(7,961,000)	$	(16,439,000)	$	(24,234,000)
Other comprehensive (loss) income:
Foreign currency translation adjustments	(493,000)		42,000		(687,000)		111,000
Total other comprehensive (loss) income	(493,000)		42,000		(687,000)		111,000
Comprehensive loss	(16,035,000)		(7,919,000)		(17,126,000)		(24,123,000)
Comprehensive (income) loss attributable to noncontrolling interests	(1,768,000)		283,000		(3,827,000)		4,709,000
Comprehensive loss attributable to controlling interest	$	(17,803,000)	$	(7,636,000)	$	(20,953,000)	$	(19,414,000)


	Three Months Ended June 30, 2022
	Stockholders’ Equity
	Common Stock
	Number of Shares	Amount		Additional Paid-In Capital		Accumulated Deficit		Accumulated Other Comprehensive Loss		Total Stockholders’ Equity		Noncontrolling Interests		Total Equity
BALANCE — March 31, 2022	263,809,729	$	2,629,000	$	2,536,811,000	$	(980,613,000)	$	(2,160,000)	$	1,556,667,000	$	174,154,000	$	1,730,821,000

Offering costs — common stock	—	—		1,000		—		—		1,000		—		1,000
Issuance of common stock under the DRIP	1,199,427	12,000		11,131,000		—		—		11,143,000		—		11,143,000
Issuance of nonvested restricted common stock	54,900	1,000		(1,000)		—		—		—		—		—
Amortization of nonvested restricted common stock and stock units	—	—		980,000		—		—		980,000		—		980,000


Stock based compensation	—	—		—		—		—		—		21,000		21,000
Repurchase of common stock	(699,460)	(7,000)		(6,442,000)		—		—		(6,449,000)		—		(6,449,000)

Distributions to noncontrolling interests	—	—		—		—		—		—		(3,537,000)		(3,537,000)

Reclassification of noncontrolling interests to mezzanine equity	—	—		—		—		—		—		(21,000)		(21,000)
Adjustment to value of redeemable noncontrolling interests	—	—		(976,000)		—		—		(976,000)		(1,000)		(977,000)
Distributions declared ($0.10 per share)	—	—		—		(26,405,000)		—		(26,405,000)		—		(26,405,000)
Net (loss) income	—	—		—		(17,310,000)		—		(17,310,000)		1,986,000		(15,324,000)		(1)
Other comprehensive loss	—	—		—		—		(493,000)		(493,000)		—		(493,000)
BALANCE — June 30, 2022	264,364,596	$	2,635,000	$	2,541,504,000	$	(1,024,328,000)	$	(2,653,000)	$	1,517,158,000	$	172,602,000	$	1,689,760,000


☒			QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended June 30, 2022


☐			TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from to


	Three Months Ended June 30, 2021
	Stockholders’ Equity
	Common Stock
	Number of Shares	Amount		Additional Paid-In Capital		Accumulated Deficit		Accumulated Other Comprehensive Loss		Total Stockholders’ Equity		Noncontrolling Interests		Total Equity
BALANCE — March 31, 2021	179,658,367	$	1,798,000	$	1,730,237,000	$	(876,118,000)	$	(1,939,000)	$	853,978,000	$	164,095,000	$	1,018,073,000




Amortization of nonvested restricted common stock	—	—		26,000		—		—		26,000		—		26,000





Distributions to noncontrolling interests	—	—		—		—		—		—		(179,000)		(179,000)


Adjustment to value of redeemable noncontrolling interests	—	—		(261,000)		—		—		(261,000)		(112,000)		(373,000)
Distributions declared ($0.02 per share)	—	—		—		(3,187,000)		—		(3,187,000)		—		(3,187,000)
Net loss	—	—		—		(7,678,000)		—		(7,678,000)		(253,000)		(7,931,000)		(1)
Other comprehensive income	—	—		—		—		42,000		42,000		—		42,000
BALANCE — June 30, 2021	179,658,367	$	1,798,000	$	1,730,002,000	$	(886,983,000)	$	(1,897,000)	$	842,920,000	$	163,551,000	$	1,006,471,000


	Six Months Ended June 30, 2022
	Stockholders’ Equity
	Common Stock
	Number of Shares	Amount		Additional Paid-In Capital		Accumulated Deficit		Accumulated Other Comprehensive Loss		Total Stockholders’ Equity		Noncontrolling Interests		Total Equity
BALANCE — December 31, 2021	263,032,031	$	2,622,000	$	2,531,940,000	$	(951,303,000)	$	(1,966,000)	$	1,581,293,000	$	175,553,000	$	1,756,846,000

Offering costs — common stock	—	—		(2,000)		—		—		(2,000)		—		(2,000)
Issuance of common stock under the DRIP	2,425,500	24,000		22,423,000		—		—		22,447,000		—		22,447,000
Issuance of nonvested restricted common stock	54,900	1,000		(1,000)		—		—		—		—		—
Amortization of nonvested restricted common stock and stock units	—	—		1,791,000		—		—		1,791,000		—		1,791,000


Stock based compensation	—	—		—		—		—		—		42,000		42,000
Repurchase of common stock	(1,147,835)	(12,000)		(10,571,000)		—		—		(10,583,000)		—		(10,583,000)

Distributions to noncontrolling interests	—	—		—		—		—		—		(7,052,000)		(7,052,000)

Adjustment to noncontrolling interest in connection with the Merger	—	—		(1,173,000)		—		—		(1,173,000)		1,173,000		—
Reclassification of noncontrolling interests to mezzanine equity	—	—		—		—		—		—		(42,000)		(42,000)
Adjustment to value of redeemable noncontrolling interests	—	—		(2,903,000)		—		—		(2,903,000)		(930,000)		(3,833,000)
Distributions declared ($0.20 per share)	—	—		—		(52,759,000)		—		(52,759,000)		—		(52,759,000)
Net (loss) income	—	—		—		(20,266,000)		—		(20,266,000)		3,858,000		(16,408,000)		(1)
Other comprehensive loss	—	—		—		—		(687,000)		(687,000)		—		(687,000)
BALANCE — June 30, 2022	264,364,596	$	2,635,000	$	2,541,504,000	$	(1,024,328,000)	$	(2,653,000)	$	1,517,158,000	$	172,602,000	$	1,689,760,000


	Six Months Ended June 30, 2021
	Stockholders’ Equity
	Common Stock
	Number of Shares	Amount		Additional Paid-In Capital		Accumulated Deficit		Accumulated Other Comprehensive Loss		Total Stockholders’ Equity		Noncontrolling Interests		Total Equity
BALANCE — December 31, 2020	179,658,367	$	1,798,000	$	1,730,589,000	$	(864,271,000)	$	(2,008,000)	$	866,108,000	$	168,375,000	$	1,034,483,000

Offering costs — common stock	—	—		(1,000)		—		—		(1,000)		—		(1,000)


Amortization of nonvested restricted common stock	—	—		53,000		—		—		53,000		—		53,000
Stock based compensation	—	—		—		—		—		—		(14,000)		(14,000)




Distributions to noncontrolling interests	—	—		—		—		—		—		(355,000)		(355,000)


Adjustment to value of redeemable noncontrolling interests	—	—		(639,000)		—		—		(639,000)		(260,000)		(899,000)
Distributions declared ($0.02 per share)	—	—		—		(3,187,000)		—		(3,187,000)		—		(3,187,000)
Net loss	—	—		—		(19,525,000)		—		(19,525,000)		(4,195,000)		(23,720,000)		(1)
Other comprehensive income	—	—		—		—		111,000		111,000		—		111,000
BALANCE — June 30, 2021	179,658,367	$	1,798,000	$	1,730,002,000	$	(886,983,000)	$	(1,897,000)	$	842,920,000	$	163,551,000	$	1,006,471,000


	Private and Other Payors		Medicare		Medicaid		Total
Beginning balance — January 1, 2022	$	42,056,000	$	35,953,000	$	16,922,000	$	94,931,000
Ending balance — June 30, 2022	45,514,000		35,844,000		19,678,000		101,036,000
Increase/(decrease)	$	3,458,000	$	(109,000)	$	2,756,000	$	6,105,000


	Total
Beginning balance — January 1, 2022	$	14,673,000
Ending balance — June 30, 2022	16,405,000
Increase	$	1,732,000


	June 30, 2022		December 31, 2021
Building, improvements and construction in process	$	3,536,965,000	$	3,505,786,000
Land and improvements	335,330,000		334,562,000
Furniture, fixtures and equipment	208,194,000		198,224,000
	4,080,489,000		4,038,572,000
Less: accumulated depreciation	(588,644,000)		(523,886,000)
	$	3,491,845,000	$	3,514,686,000


	2022 Acquisitions
Building and improvements	$	49,645,000
Land and improvements	8,173,000




Total assets acquired	$	57,818,000


	2022 Acquisitions
Building and improvements	$	17,273,000
Land	3,060,000
In-place leases	3,420,000
Goodwill	2,816,000
Furniture, fixtures and equipment	1,936,000
Cash	971,000
Certificates of need	690,000
Operating lease right-of-use assets	646,000
Other assets	457,000
Accounts receivable	427,000
Total assets acquired	31,696,000
Security deposits	(8,129,000)
Accounts payable and accrued liabilities	(1,802,000)
Operating lease liabilities	(646,000)
Financing obligations	(56,000)
Total liabilities assumed	(10,633,000)
Net assets acquired	$	21,063,000


	Six Months Ended June 30,
	2022		2021
Security deposits and other	$	(464,000)	$	117,000
Net cash provided by financing activities	19,924,000		86,471,000
NET CHANGE IN CASH, CASH EQUIVALENTS AND RESTRICTED CASH	$	(21,302,000)	$	(34,115,000)
EFFECT OF FOREIGN CURRENCY TRANSLATION ON CASH, CASH EQUIVALENTS AND RESTRICTED CASH	(8,000)		(27,000)
CASH, CASH EQUIVALENTS AND RESTRICTED CASH — Beginning of period	125,486,000		152,190,000
CASH, CASH EQUIVALENTS AND RESTRICTED CASH — End of period	$	104,176,000	$	118,048,000

RECONCILIATION OF CASH, CASH EQUIVALENTS AND RESTRICTED CASH
Beginning of period:
Cash and cash equivalents	$	81,597,000	$	113,212,000
Restricted cash	43,889,000		38,978,000
Cash, cash equivalents and restricted cash	$	125,486,000	$	152,190,000

End of period:
Cash and cash equivalents	$	59,101,000	$	76,659,000
Restricted cash	45,075,000		41,389,000
Cash, cash equivalents and restricted cash	$	104,176,000	$	118,048,000

SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION
Cash paid for:
Interest	$	36,348,000	$	32,984,000
Income taxes	$	382,000	$	861,000
SUPPLEMENTAL DISCLOSURE OF NONCASH INVESTING AND FINANCING ACTIVITIES
Accrued developments and capital expenditures	$	14,055,000	$	18,074,000


Tenant improvement overage	$	568,000	$	177,000









Issuance of common stock under the DRIP	$	22,447,000	$	—


	Three Months Ended June 30,
	2022						2021
	Integrated Senior Health Campuses		SHOP(1)		Total		Integrated Senior Health Campuses		SHOP(1)		Total
Over time	$	232,839,000	$	37,891,000	$	270,730,000	$	204,729,000	$	20,039,000	$	224,768,000
Point in time	54,743,000		752,000		55,495,000		51,086,000		498,000		51,584,000
Total resident fees and services	$	287,582,000	$	38,643,000	$	326,225,000	$	255,815,000	$	20,537,000	$	276,352,000


	Six Months Ended June 30,
	2022						2021
	Integrated Senior Health Campuses		SHOP(1)		Total		Integrated Senior Health Campuses		SHOP(1)		Total
Over time	$	463,373,000	$	75,107,000	$	538,480,000	$	392,987,000	$	39,498,000	$	432,485,000
Point in time	105,221,000		1,498,000		106,719,000		96,054,000		839,000		96,893,000
Total resident fees and services	$	568,594,000	$	76,605,000	$	645,199,000	$	489,041,000	$	40,337,000	$	529,378,000


	Three Months Ended June 30,
	2022						2021
	Integrated Senior Health Campuses		SHOP(1)		Total		Integrated Senior Health Campuses		SHOP(1)		Total
Private and other payors	$	137,419,000	$	35,632,000	$	173,051,000	$	112,747,000	$	20,257,000	$	133,004,000
Medicare	93,680,000		—		93,680,000		87,885,000		—		87,885,000
Medicaid	56,483,000		3,011,000		59,494,000		55,183,000		280,000		55,463,000
Total resident fees and services	$	287,582,000	$	38,643,000	$	326,225,000	$	255,815,000	$	20,537,000	$	276,352,000


	June 30, 2022		December 31, 2021
Intangible assets subject to amortization:
In-place leases, net of accumulated amortization of $31,132,000 and $28,120,000 as of June 30, 2022 and December 31, 2021, respectively (with a weighted average remaining life of 8.1 years and 8.2 years as of June 30, 2022 and December 31, 2021, respectively)	$	72,431,000	$	81,538,000
Above-market leases, net of accumulated amortization of $4,306,000 and $2,082,000 as of June 30, 2022 and December 31, 2021, respectively (with a weighted average remaining life of 9.4 years and 9.7 years as of June 30, 2022 and December 31, 2021, respectively)	32,849,000		35,106,000
Customer relationships, net of accumulated amortization of $710,000 and $635,000 as of June 30, 2022 and December 31, 2021, respectively (with a weighted average remaining life of 14.2 years and 14.7 years as of June 30, 2022 and December 31, 2021, respectively)	2,130,000		2,205,000
Internally developed technology and software, net of accumulated amortization of $446,000 and $399,000 as of June 30, 2022 and December 31, 2021, respectively (with a weighted average remaining life of 0.2 years and 0.7 years as of June 30, 2022 and December 31, 2021, respectively)	24,000		70,000
Intangible assets not subject to amortization:
Certificates of need	96,693,000		99,165,000
Trade names	30,787,000		30,787,000
	$	234,914,000	$	248,871,000


Year	Amount
2022	$	10,892,000
2023	17,148,000
2024	13,657,000
2025	11,018,000
2026	9,848,000
Thereafter	44,871,000
	$	107,434,000


	June 30, 2022		December 31, 2021
Deferred rent receivables	$	44,290,000	$	41,061,000
Prepaid expenses, deposits, other assets and deferred tax assets, net	36,281,000		22,484,000
Investments in unconsolidated entities	23,326,000		15,615,000
Inventory	18,649,000		18,929,000
Lease commissions, net of accumulated amortization of $5,460,000 and $4,911,000 as of June 30, 2022 and December 31, 2021, respectively	16,758,000		16,120,000

Deferred financing costs, net of accumulated amortization of $4,340,000 and $8,469,000 as of June 30, 2022 and December 31, 2021, respectively	5,466,000		3,781,000
Lease inducement, net of accumulated amortization of $2,018,000 and $1,842,000 as of June 30, 2022 and December 31, 2021, respectively (with a weighted average remaining life of 8.4 years and 8.9 years as of June 30, 2022 and December 31, 2021, respectively)	2,982,000		3,158,000
	$	147,752,000	$	121,148,000


	June 30, 2022		December 31, 2021
Total fixed-rate debt	$	826,465,000	$	845,504,000
Total variable-rate debt	326,533,000		270,712,000
Total fixed- and variable-rate debt	1,152,998,000		1,116,216,000
Less: deferred financing costs, net	(8,525,000)		(8,680,000)
Add: premium	314,000		397,000
Less: discount	(10,728,000)		(12,339,000)
Mortgage loans payable, net	$	1,134,059,000	$	1,095,594,000


Instrument	Notional Amount		Index	Interest Rate	Maturity Date	Fair Value December 31, 2021
Swap	$	250,000,000	one month LIBOR	2.10%	01/25/22	$	332,000
Swap	$	130,000,000	one month LIBOR	1.98%	01/25/22	162,000
Swap	$	100,000,000	one month LIBOR	0.20%	01/25/22	6,000
						$	500,000


Approval Date by our Board	Estimated Per Share NAV (Unaudited)



10/03/19	$	9.40
03/18/21	$	8.55
03/24/22	$	9.29


	Three Months Ended June 30, 2021		Six Months Ended June 30, 2021
Asset management fees(1)	$	5,401,000	$	10,763,000
Property management fees(2)	681,000		1,335,000
Development fees(3)	357,000		640,000
Lease fees(4)	120,000		385,000
Construction management fees(5)	68,000		80,000
Operating expenses(6)	53,000		116,000
Acquisition fees(7)	10,000		1,344,000
	$	6,690,000	$	14,663,000


Fee	December 31, 2021
Lease commissions	$	245,000
Development fees	229,000
Construction management fees	152,000
Operating expenses	100,000
Asset and property management fees	83,000
Acquisition fees	57,000



	$	866,000


	Quoted Prices in Active Markets for Identical Assets and Liabilities (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Total



Liabilities:
Warrants	$	—	$	—	$	733,000	$	733,000
Total liabilities at fair value	$	—	$	—	$	733,000	$	733,000


	June 30, 2022				December 31, 2021
	Carrying Amount(1)		Fair Value		Carrying Amount(1)		Fair Value
Financial Assets:

Debt security investment	$	81,167,000	$	93,470,000	$	79,315,000	$	93,920,000
Financial Liabilities:
Mortgage loans payable	$	1,134,059,000	$	1,020,652,000	$	1,095,594,000	$	1,075,729,000
Lines of credit and term loans	$	1,261,225,000	$	1,270,330,000	$	1,222,853,000	$	1,226,636,000


		Three Months Ended June 30,
Lease Cost	Classification	2022		2021
Operating lease cost(1)	Property operating expenses, rental expenses or general and administrative expenses	$	5,408,000	$	5,498,000
Finance lease cost:
Amortization of leased assets	Depreciation and amortization	316,000		381,000
Interest on lease liabilities	Interest expense	66,000		74,000
Sublease income	Resident fees and services revenue or other income	(234,000)		(6,000)
Total lease cost		$	5,556,000	$	5,947,000


Lease Term and Discount Rate	June 30, 2022		December 31, 2021
Weighted average remaining lease term (in years):
Operating leases	19.9		16.9
Finance leases	2.9		3.6
Weighted average discount rate:
Operating leases	5.53	%	5.52	%
Finance leases	7.59	%	7.68	%


	Six Months Ended June 30,
Supplemental Disclosure of Cash Flows Information	2022		2021

Operating cash outflows related to finance leases	$	140,000	$	192,000
Financing cash outflows related to finance leases	$	26,000	$	117,000
Leased assets obtained in exchange for finance lease liabilities	$	56,000	$	136,000
Right-of-use assets obtained in exchange for operating lease liabilities	$	—	$	105,000


	Integrated Senior Health Campuses		SHOP		Medical Office Buildings		Senior Housing — Leased		Skilled Nursing Facilities		Hospitals		Three Months Ended June 30, 2022
Revenues and grant income:
Resident fees and services	$	287,582,000	$	38,643,000	$	—	$	—	$	—	$	—	$	326,225,000
Real estate revenue	—		—		36,833,000		5,262,000		6,599,000		2,411,000		51,105,000
Grant income	10,969,000		—		—		—		—		—		10,969,000
Total revenues and grant income	298,551,000		38,643,000		36,833,000		5,262,000		6,599,000		2,411,000		388,299,000
Expenses:
Property operating expenses	258,934,000		37,125,000		—		—		—		—		296,059,000
Rental expenses	—		—		13,791,000		212,000		521,000		139,000		14,663,000
Segment net operating income	$	39,617,000	$	1,518,000	$	23,042,000	$	5,050,000	$	6,078,000	$	2,272,000	$	77,577,000
Expenses:
General and administrative													$	10,928,000
Business acquisition expenses													1,757,000
Depreciation and amortization													39,971,000
Other income (expense):

Interest expense (including amortization of deferred financing costs, debt discount/premium and gain on debt extinguishments)													(20,345,000)

Loss on dispositions of real estate investments													(73,000)
Impairment of real estate investments													(17,340,000)
Income from unconsolidated entities													638,000
Foreign currency loss													(3,607,000)
Other income													469,000
Total net other expense													(40,258,000)
Loss before income taxes													(15,337,000)
Income tax expense													(205,000)


Net loss													$	(15,542,000)


	June 30, 2022		December 31, 2021
Integrated senior health campuses	$	1,911,026,000	$	1,896,608,000
Medical office buildings	1,385,279,000		1,412,247,000
SHOP	599,528,000		625,164,000
Skilled nursing facilities	250,019,000		252,869,000
Senior housing — leased	249,499,000		255,555,000
Hospitals	107,488,000		109,834,000
Other	21,061,000		28,062,000
Total assets	$	4,523,900,000	$	4,580,339,000


	June 30, 2022		December 31, 2021
Real estate investments, net:
United States	$	3,448,793,000	$	3,466,019,000
International	43,052,000		48,667,000
	$	3,491,845,000	$	3,514,686,000


	June 30,
	2022					2021
	Number of Buildings/ Campuses	Aggregate Contract Purchase Price		Leased %		Number of Buildings/ Campuses	Aggregate Contract Purchase Price		Leased %
Integrated senior health campuses	122	$	1,865,786,000	(1)		120	$	1,754,233,000	(1)
Medical office buildings	105	1,249,658,000		90.3	%	63	657,885,000		89.3	%
SHOP	47	708,050,000		(2)		20	433,891,000		(2)
Senior housing — leased	20	169,885,000		100	%	9	89,535,000		100	%
Skilled nursing facilities	17	237,300,000		100	%	6	119,500,000		100	%
Hospitals	2	139,780,000		100	%	2	139,780,000		100	%
Total/weighted average(3)	313	$	4,370,459,000	93.1	%	220	$	3,194,824,000	92.0	%


	Payments Due by Period
	2022		2023-2024		2025-2026		Thereafter		Total
Principal payments — fixed-rate debt	$	25,507,000	$	106,157,000	$	184,034,000	$	510,768,000	$	826,466,000
Interest payments — fixed-rate debt	12,890,000		46,823,000		38,564,000		202,140,000		300,417,000
Principal payments — variable-rate debt	221,000		610,976,000		413,626,000		569,345,000		1,594,168,000
Interest payments — variable-rate debt (based on rates in effect as of June 30, 2022)	29,239,000		83,219,000		51,603,000		4,235,000		168,296,000
Ground and other lease obligations	7,116,000		26,858,000		22,672,000		144,289,000		200,935,000
Financing obligations	2,702,000		5,366,000		3,048,000		16,241,000		27,357,000
Total	$	77,675,000	$	879,399,000	$	713,547,000	$	1,447,018,000	$	3,117,639,000


	Six Months Ended June 30, 2022
Distributions paid in cash		$	30,247,000
Distributions reinvested		22,447,000
		$	52,694,000
Sources of distributions:
Cash flows from operations		$	52,694,000	100	%
Proceeds from borrowings		—		—

		$	52,694,000	100	%


	Expected Maturity Date
	2022			2023			2024			2025			2026			Thereafter			Total			Fair Value
Assets
Debt security held-to-maturity	$	—		$	—		$	—		$	93,433,000		$	—		$	—		$	93,433,000		$	93,470,000
Weighted average interest rate on maturing fixed-rate debt security	—		%	—		%	—		%	4.24		%	—		%	—		%	4.24		%	—
Liabilities
Fixed-rate debt — principal payments	$	25,507,000		$	34,521,000		$	71,636,000		$	29,107,000		$	154,927,000		$	510,768,000		$	826,466,000		$	690,787,000
Weighted average interest rate on maturing fixed-rate debt	3.92		%	3.78		%	3.53		%	3.35		%	2.98		%	3.01		%	3.12		%	—
Variable-rate debt — principal payments	$	221,000		$	452,891,000		$	158,085,000		$	356,000		$	413,270,000		$	569,345,000		$	1,594,168,000		$	1,600,195,000
Weighted average interest rate on maturing variable-rate debt (based on rates in effect as of June 30, 2022)	5.00		%	4.17		%	3.82		%	3.81		%	3.25		%	3.22		%	3.59		%	—